Development of an internet intervention to address behaviors associated with skin cancer risk among young adults

Abstract

Purpose Skin cancer is the most common cancer in the US, and its incidence is increasing. The major risk factor for skin cancer is exposure to ultraviolet radiation (UV). Young adults tend to expose themselves to large amounts of UV and engage in minimal skin protection, which increases their skin cancer risk. Interventions are needed to address risk behaviors among young adults that may lead to skin cancer. The nternet offers a cost-effective way to widely disseminate efficacious interventions. The current paper describes the development of an online skin cancer risk reduction intervention (UV4.me) for young adults. Procedures The iterative development process for UV4.me followed best-practice guidelines and included the following activities: individual interviews, focus groups, content development by the expert team, acceptability testing, cognitive interviewing for questionnaires, quality control testing, usability testing, and a pilot randomized controlled trial. Participant acceptability and usability feedback was assessed. Principal Results The development process produced an evidence-informed intervention that is individually-tailored, interactive, and multimedia in nature based on the Integrative Model of Behavior Prediction, a model for internet interventions, and other best-practice recommendations, expert input, as well as user acceptability and usability feedback gathered before, during, and after development. Major Conclusions Development of an acceptable intervention intended to have a significant public health impact requires a relatively large investment in time, money, expertise, and ongoing user input. Lessons learned and recommendations are discussed. The comprehensive process used may help prepare others interested in creating similar behavioral health interventions.

Development of a self-guided web-based intervention to promote physical activity using the multi-process action control framework

“…We monitored how easily participants were able to complete tasks including: finding additional information about the creation team under the “about us” section, finding in text citations and corresponding full citations in the reference page, playing videos, completing lesson activities, and completing the lesson summary quiz. At the end of the assessment, participants completed a structured usability interview (Heckman et al, 2015), a system usability scale questionnaire (Brooke, 1996), and an acceptability survey (Heckman et al, 2015). The usability scale ranged from 0 to 100 and a score above 68 indicates above-average usability (Brooke, 1996).…”

“…The acceptability score of the web-based intervention consists of three categories: likeability; usefulness; and personal applicability. The score is on a scale of 0–10, with 10 being the most acceptable and 0 being the least acceptable (Heckman et al, 2015). One research staff member, with experience in qualitative data collection, administered a structured interview to access features that the participants found most, and least, helpful.…”

Participatory Methods to Engage Health Service Users in the Development of Electronic Health Resources: Systematic Review

“…Heckman [ 45 ] reported that their eHealth initiative was guided by intervention development, assessment guidelines for behavioral therapy, and health communication programs with health literacy best-practice. Utilizing a participatory design appeared to improve the relevance of the eHealth resource by addressing issues of culture, gender, age, and sexuality ( Multimedia Appendix 6 ).…”

“…Goldenberg [ 42 , 43 ] reported personalization along with interactive functionality promoted ownership for HSU. A majority of projects included both HSU and HSP in participatory methods across different developmental stages from contextual inquiry to summative evaluation of the project [ 28 , 29 , 31 , 34 - 38 , 40 - 43 , 45 - 55 , 58 - 61 , 63 - 67 , 69 ]. Evaluation is an integral part of participatory methodology; however, this was reported inconsistently across the 30 studies ( Multimedia Appendix 8 ).…”

Recall of indoor tanning salon warnings and safety guidelines among a national sample of tanners

“…Skin type was assessed by asking participants the color of their non-sun-exposed skin (very fair, fair, olive, light brown, medium brown, dark brown, or black) [29]. This item was developed as part of a comprehensive, reliable, and frequently utilized skin cancer risk assessment measure [29][30][31].…”